Provider Demographics
NPI:1295002996
Name:MONACO, LIBERATORE P (MD)
Entity Type:Individual
Prefix:DR
First Name:LIBERATORE
Middle Name:P
Last Name:MONACO
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:20 HAGEN DR
Mailing Address - Street 2:SUITE 110
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14625-2666
Mailing Address - Country:US
Mailing Address - Phone:585-267-4035
Mailing Address - Fax:585-267-4037
Practice Address - Street 1:20 HAGEN DR
Practice Address - Street 2:SUITE 110
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14625-2666
Practice Address - Country:US
Practice Address - Phone:585-267-4035
Practice Address - Fax:585-267-4037
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-23
Last Update Date:2011-11-23
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY1136308207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYD79128Medicare UPIN